Cannulated syringe

ABSTRACT

A set of instruments configured to deliver a therapy to a bone can include a cannulated syringe. The cannulated syringe can extend along a longitudinal axis between a proximal and a distal end. The cannulated syringe can have an inner tube and an outer tube that are interconnected at the distal end as a single fixed unit. A first cannulation can be formed along the longitudinal axis of the cannulated syringe within the inner tube and a second cannulation can be formed within an annular space between the inner and outer tubes. The outer tube can define an opening through a sidewall thereof. The cannulated syringe can be closed from fluid communication between the inner and outer tubes.

INTRODUCTION

The present technology relates generally to biologic material deliverysystems and more specifically to a set of instruments and related methodfor delivering biologic material to a bone.

In some instances during treatment of fractures on various long bones,such as diaphyseal fractures of the femur, tibia and humerus bones, itmay be desirable to introduce a flowable biologic material through theIM (IM) canal of the bone. The biologic material can be introducedalone, or in combination with an IM nail. In this regard, an IM nail canhave an elongated metallic member that includes one or more cylindricalcavities that can be perpendicular to the long axis of the IM nail forreceiving a fastener element, such as a transcortical screw. The IM nailcan be positioned within the medullary cavity and can be secured to theproximal and distal fracture segments using transcortical screws, whichpenetrate both cortices of the bone, as well as pass through thecylindrical cavities formed in the IM nail.

According to one surgical technique, a guide wire can be located intothe IM canal past the fracture. A cannulated reamer can then locatearound the guide wire to ream the IM canal for placement of the IM nail.The guide wire can also be used to guide the IM nail into position oncethe IM canal has been sufficiently reamed. As identified above, in someexamples, it may be desired to also introduce biologic material into theIM canal around the fracture prior to implanting the IM nail. In somecases, it can be challenging to introduce biologic material near thefracture site while isolating the guide wire from contact with thebiologic material and leaving the guide wire in place for laterreference of the IM nail. Additionally, it is undesirable to remove theguide wire after reaming and reintroducing it to guide the insertion ofthe IM nail.

SUMMARY

A set of instruments configured to deliver a therapy to a bone caninclude a cannulated syringe. The cannulated syringe can extend along alongitudinal axis between a proximal and a distal end. The cannulatedsyringe can have an inner tube and an outer tube that are interconnectedat the distal end as a single fixed unit. A first cannulation can beformed along the longitudinal axis of the cannulated syringe within theinner tube and a second cannulation can be formed within an annularspace between the inner and outer tubes. The outer tube can define anopening through a sidewall thereof. The cannulated syringe can be closedfrom fluid communication between the inner and outer tubes.

According to additional features, the opening in the outer tube caninclude an oblong slot. The inner tube can be longer than the outertube, such that the inner tube extends proud from the proximal endrelative to the outer tube. The cannulated syringe can further include ahandle that is disposed on the proximal end and that extends generallytransverse to the longitudinal axis.

The set of instruments can further include a plunger that has a tubularbody that is configured to slidably advance through the secondcannulation in a direction toward the distal end. The plunger can have agripping portion that is disposed on a proximal end thereof. The set ofinstruments can further include a piston that has a tubular body that isconfigured to slidably advance through the second cannulation uponurging from the plunger.

The set of instruments can further comprise a valve body and a lockingmember. The valve body can have a central passage that is sized toslidably advance onto the distal end of the cannulated syringe in anoperating position. The valve body can have a locking aperture and avalve inlet formed thereon. The valve inlet can be adapted to fluidlyconnect with the opening of the outer tube in the operating position.The locking member can be adapted to selectively locate through thelocking aperture of the valve body and into the opening of the outertube thereby inhibiting slidable translation of the valve body along theouter tube of the cannulated syringe.

The valve body can have an annular channel formed around an innerdiameter that fluidly connects the valve inlet and the opening in theouter tube of the cannulated syringe in the operating position. Thelocking member can be adapted to create a fluid tight seal at thelocking aperture in an installed position. The locking member can have adistal end that has a cross-section less than the opening in the outertube, such that fluid is permitted to pass through the opening in theouter tube when the locking member is in the installed position.

The set of instruments can further include a plug that has a tubularbody that is configured to slidably advance through the secondcannulation in a direction toward the distal end. The plug can have acollar on a proximal end that is adapted to engage a proximal terminalend of the outer tube in an advanced position while the inner tubelocates through the tubular body of the plug. The plug can furtherinclude elastomeric seals at distal and proximal ends that are adaptedto form a fluid tight seal between the inner and outer tubes in theadvanced position. According to some examples, a valve attachment can bedisposed on the valve body that fluidly connects to the valve inlet. Thevalve attachment can have threads formed thereon that are adapted tothreadably mate with a fluid delivery device.

Further areas of applicability will become apparent from the descriptionprovided herein. The description and specific examples in this summaryare intended for purposes of illustration only and are not intended tolimit the scope of the present disclosure.

DRAWINGS

The drawings described herein are for illustrative purposes only ofselected embodiments and not all possible implementations, and are notintended to limit the scope of the present disclosure.

FIG. 1 is an exploded perspective view of an instrument set configuredto deliver a therapy to a bone constructed in accordance to one exampleof the present teachings;

FIG. 2 is a cross-sectional view of the cannulated syringe, valve bodyand plug shown during initial introduction of a biologic material intoan outer cannulation defined by the cannulated syringe;

FIG. 3 is a cross-sectional view of the cannulated syringe, valve bodyand plug shown with the plug advanced to a sealing position into theproximal end of the cannulated syringe;

FIG. 4 is an exploded cross-sectional view of the valve member, a valveattachment and a locking member of the instrument set shown in FIG. 1;

FIG. 5 is an exploded cross-sectional view of the valve member, valveattachment and locking member shown with a distal tip of the lockingmember located into a locking aperture of the valve body;

FIG. 6 is a cross-sectional view of the valve body and valve attachmentshown with a syringe withdrawing air from the outer cannulation of thecannulated syringe;

FIG. 7 is a cross-sectional view of the valve body, valve attachment andlocking member shown with the syringe introducing a hydrating fluid intothe outer cannulation of the cannulated syringe;

FIG. 8 is a detailed view of the valve body of FIG. 7 shown duringintroduction of the hydrating fluid into the outer cannulation of thecannulated syringe during hydration of the biologic material;

FIG. 9 is a cross-sectional view of the cannulated syringe shown withthe valve body removed and the biologic material in a hydrated state;

FIG. 10 is a cross-sectional view of the cannulated syringe shownadvanced over a guide wire extending from an IM canal of a tibia; and

FIG. 11 is a cross-sectional view of the cannulated syringe of FIG. 10and shown with a plunger being advanced toward the distal end of thecannulated syringe, such that the biologic material is expelled throughan opening formed in an outer tube of the cannulated syringe.

Corresponding reference numerals indicate corresponding parts throughoutthe several views of the drawings.

DETAILED DESCRIPTION

The following description of technology is merely exemplary in nature ofthe subject matter, manufacture and use of one or more inventions, andis not intended to limit the scope, application, or uses of any specificinvention claimed in this application or in such other applications asmay be filed claiming priority to this application, or patents issuingtherefrom. Moreover, although the following description andillustrations refer specifically to an intraoperative introduction ofbiologic material during an IM (IM) nailing of a tibia, it will beunderstood that the instruments and related method disclosed herein maybe applied to other applications. For example, the instruments disclosedherein may be used to introduce biologic material along an IM canal ofother bones, such as a humerus or femur for example. Therefore, it willbe understood that the present description and the claims are applicableto any appropriate bone in the body. A non-limiting discussion of termsand phrases intended to aid understanding of the present technology isprovided at the end of this Detailed Description.

With initial reference to FIG. 1, an instrument set that may be usedduring intraoperative introduction of biologic material into bone, suchas during an IM nailing is shown and generally identified at referencenumeral 10. The instrument set 10 can generally include a cannulatedsyringe 12, a plug 14, a plunger 16, a valve body 18, a valve attachment20 and a locking member 22. By way of example, injectable material 24 isshown in a freeze-dried state and can include any biologic material thatcan facilitate healing, such as demineralized bone matrix (DBM). Theinjectable material 24 is illustrated as generally having a pair of halfcylindrical troughs 26. As will become appreciated more fully from thefollowing discussion, the instrument set 10 can be used to initiallyhydrate the freeze-dried DBM and subsequently expel the injectablematerial 24 at a desired delivery site, such as adjacent to fractures 27in the tibia 28 (see FIGS. 10 and 11).

The cannulated syringe 12 can generally include an inner tube 30 and anouter tube 32. The outer tube 32 can be radially stepped outwardly fromthe inner tube 30. The cannulated syringe 12 can therefore provide adual cannulation with an inner cannulation 34 defined within the innertube 30 and an outer cannulation 36 defined by the annular space createdbetween the inner tube 30 and the outer tube 32. The cannulated syringe12 can generally extend along a longitudinal axis 38 between a distalend 40 and a proximal end 42. The distal end 40 can be defined as anyportion of the cannulated syringe 12 that is at the distal opening ofthe inner cannulation 34 or a distance proximal therefrom.

A tapered distal tip 46 can be formed at the distal end 40 thatgenerally connects the inner tube 30 with the outer tube 32. In someexamples, the tapered distal tip 46 can be a separate piece that isconnected to both of the inner and outer tubes 30 and 32. The tapereddistal tip 40 can be connected in any manner such that a fluid tightseal is created between the inner and outer tubes 30 and 32 at thedistal end 40. In this regard, the cannulated syringe 12 is closed fromfluid communication between the inner and outer tubes 30 and 32.

An opening 44 can be formed at the distal end 40. In one example, theopening 44 can be formed through the outer tube 32. The opening 44 canbe formed at any distance proximal from the distal opening of the innercannulation 34. In one example, the opening 44 can be provided at alocation within the distal most one-quarter of the entire length of thecannulated syringe 12. In some examples, the opening 44 can beadditionally or alternatively formed through the tapered distal tip 46.In the exemplary configuration, a centerpoint of the opening 44 islocated at a distance measured from the distal opening of the innercannulation 34 to about one-fifteenth of the entire length of thecannulated syringe 12. The opening 44 can be non-circular such as anoblong slot for example. In one example, the opening 44 can extendbetween about three-quarters of an inch and one inch from the distalopening of the inner cannulation 34. Other configurations arecontemplated. The opening 44 can generally extend along an axis 45 (FIG.4) that is non-parallel to and intersects the longitudinal axis 38.Other shapes and configurations are contemplated.

In one example, the inner tube 30 can extend proud from the outer tube32 at the proximal end 42. A handle 50 can be fixedly connected near theproximal end 42 of the cannulated syringe 12. In one example, the handle50 can have a looped connection portion 52 that defines an opening 54that receives the outer tube 32 of the cannulated syringe 12. Otherconfigurations are contemplated. In some examples, the cannulatedsyringe 12 can further include a piston 60 slidably mounted in the outercannulation 36 between the inner tube 30 and the outer tube 32. Thepiston 60 can have a ring-like shape that has a cross-section thatsubstantially matches the outer cannulation 36 for slidablecommunication therewithin (see FIG. 3). A seal or o-ring can beadditionally or alternatively incorporated relative to the piston 60.

The plug 14 will now be described in greater detail. The plug 14 can beused to create a fluid tight seal in the outer cannulation 36 at theproximal end 42 of the cannulated syringe during an evacuation andhydration sequence of the injectable material 24 as will becomeappreciated from the following discussion. The plug 14 can generallyhave a plug body 62 that extends between a distal end 64 and a proximalend 66. The plug body 62 can define a central passage 68 that extendsalong the entire length of the plug body 62 for receiving the inner tube30. The plug 14 can also include a collar 70 provided at the proximalend 66. The collar 70 can have a radial ledge 72 that can have an outerdiameter that is greater than the outer tube 32. Seals or o-rings 74 and75 can be disposed around the distal end 64 and proximal end 65 of theplug 14.

The plunger 16 can generally include a tubular body 76 that extendsbetween a distal end 78 and a proximal end 80. The plunger 16 can beused to expel the injectable material 24 through the opening 44 as willbe discussed herein. The tubular body 76 can define a cannulation 82that extends along the entire length of the plunger 16 for receiving theinner tube 30. A gripping portion 84 can be disposed near the proximalend 80 of the tubular body 76.

With continued reference to FIG. 1 and additional references to FIGS. 2and 3, the valve body 18 will be further described. The valve body 18can define a central passage 86 that can be adapted to slidably acceptthe cannulated syringe 12 therethrough as will be described in detailherein. The valve body 18 can further include a distal sleeve portion 88and a proximal sleeve portion 90. The valve body 18 can have a valveattachment mounting portion 92 that has a valve inlet body 94 extendingtherefrom. The valve inlet body 94 can define a valve inlet 95. Acylindrical pocket 96 can be provided on the valve attachment mountingportion 92 around the valve inlet body 94. A pair of seals or o-rings 98can be received in respective annular pockets 99 formed around an innerdiameter of the valve body 18 at the distal sleeve portion 88 and theproximal sleeve portion 90. A locking aperture 100 can be formed throughthe valve body 18 that connects the outer surface of the valve body 18with the central passage 86. The valve body 18 can include an innerannular channel 102 (see FIG. 4) that generally connects the valve inlet95 and the locking aperture 100 in fluid communication. As will bedescribed further herein, the annular channel 102 can provide a fluidconnection between the valve inlet 95 of the valve body 18 and theopening 44 formed in the outer tube 32 of the cannulated syringe 12.

The valve attachment 20 can generally include a valve mating portion 110on one end and a male connection portion 112 on an opposite end. Themale connection portion 112 can define threads 114 therealong. The valveattachment 20 can generally define an injection port 116 therethrough.The locking member 22 can generally include a body 120 in the shape of a“T” that has a tapered distal tip 122 and a handle 124 (as bestillustrated in FIG. 1).

An exemplary method of using the instrument set 10 during a surgicaltechnique to deliver biologic material around a tibial fracture will bedescribed. At the outset, a surgeon can select a desired injectablematerial 24, such as the freeze-dried DBM discussed above. With thepiston 60 removed from the outer cannulation 36 of the cannulatedsyringe 12, the injectable material 24 can be initially advanced intothe proximal end 42 of the cannulated syringe 12 into the outercannulation 36. While the injectable material 24 is shown generally asopposing cylindrical troughs in a pre-cast or freeze-dried state, theinjectable material 24 can take a variety of shapes and forms. Forexample, the injectable material 24 can be a continuous cylindricalmember or a collection of more than two partial segments of injectablematerial 24. Moreover, while the injectable material 24 has beenillustrated as having a length that extends a distance that is generallygreater than half of the cannulated syringe 12, the injectable material24 can be any length that provides enough biologic material that issuitable for a particular patient. Furthermore, the injectable material24 can additionally or alternatively be in a flowable or partiallyflowable state such that a surgeon can shape the injectable material 24as needed.

Once the injectable material 24 has been loaded into the outercannulation 36 at the proximal end 42 of the cannulated syringe 12, thepiston 60 can be loaded into the outer cannulation 36 at the proximalend 42 of the cannulated syringe 12 (see FIGS. 2 and 3).

The plug 14 can then be used to further advance the injectable material24 toward the distal end 40 of the cannulated syringe 12. Specifically,the distal end 64 of the plug 14 can be initially advanced to a positionadjacent the proximal end 42 of the cannulated syringe 12 until theinner tube 30 locates into the central passage 68 of the plug 14. Theplug 14 can then be further advanced toward the distal end 40 of thecannulated syringe 12, such that the plug body 62 locates progressivelyfurther into the outer cannulation 36 of the cannulated syringe 12. Theplug 14 can be further advanced until the radial ledge 72 of the collar70 abuts the outer tube 32 at the proximal end 42 of the cannulatedsyringe 12 (FIG. 3). The plug 14 can therefore provide a fluid tightseal near the proximal end 42 of the cannulated syringe 12 and morespecifically proximally relative to the injectable material 24. Theo-rings 74 and 75 arranged on the distal end 64 and proximal end 65 ofthe plug 14 alone or in combination with the piston 60 (and/or othersupplemental seals, not shown) can facilitate formation of the fluidtight seal between the inner tube 30 and the outer tube 32 in the outercannulation 36 at a location proximal relative to the injectablematerial 24.

With reference now to FIGS. 1 and 4, the valve body 18 can be slidablyadvanced onto the distal end 40 of the cannulated syringe 12. In thisregard, the tapered distal tip 46 of the cannulated syringe 12 can beadvanced through the central passage 86 of the valve body 18 until thelocking aperture 100 generally aligns with the opening 44 of the outertube 32 on the cannulated syringe 12. It is appreciated that the o-rings98 engage the outer tube 32 and cooperate to provide a fluid tight sealat the distal sleeve portion 88 and the proximal sleeve portion 90. Thetapered distal tip 122 of the locking member 22 can be advanced into thelocking aperture 100 of the valve body 18 and through the opening 44 ofthe outer tube 32 on the cannulated syringe 12 (FIG. 5). Advancing thetapered distal tip 122 of the locking member 22 through the opening 44can lock the valve body 18 from slidably advancing along the cannulatedsyringe 12.

The valve attachment 20 can then be coupled to the valve body 18. Thoseskilled in the art will readily appreciate that while the step ofcoupling the valve attachment 20 to the valve body 18 is being describedin sequence, the valve attachment 20 may already be coupled to the valvebody 18 previously. In this regard, in some examples the valveattachment 20 and the valve body 18 can be provided as a single unit.Nevertheless, inner and outer cylinders 130 and 132, respectively,provided at the valve mating portion 110 of the valve attachment 20 areadvanced into a clearance fit (FIG. 16) with the valve inlet body 94 ofthe valve body 18. In this regard, the outer cylinder 132 can locateinto the cylindrical pocket 96 formed in the valve body 18 while thevalve inlet body 94 can locate into a cylindrical pocket 134 defined inthe annular space between the inner cylinder 130 and the outer cylinder132. In some examples, a flowable adhesive can be additionally appliedat the interface between the valve attachment 20 and the valve body 18.

Turning now to FIGS. 6-8, the method will be further described. With thevalve attachment 20 coupled to the valve body 18, an auxiliary syringe140 can be fluidly connected to the valve attachment 20. For example, afemale receiving portion 142 can fluidly connect to the auxiliarysyringe 140 (such as directly as shown, or alternatively through atube). The female receiving portion 142 can have threads 146 thatthreadably mate with the threads 114 on the male connection portion 112of the valve attachment 20. It will be appreciated that the male threads112 may alternatively be provided on the syringe 140 and the femalethreads 146 provided on the valve attachment 20. Other connections canbe incorporated.

A plunger 150 associated with the auxiliary syringe 140 can bewithdrawn, such that air 152 is encouraged to evacuate the outercannulation 36 of the cannulated syringe 12. Explained in greaterdetail, retracting the plunger 150 away from the auxiliary syringe 140can create a vacuum through the injection port 116, around the annularchannel 102 in the valve body 18 through the opening 44 in the outertube 32 and ultimately within the outer cannulation 36 that houses theinjectable material 24. Notably, while the tapered distal tip 122 of thelocking member 22 extends through the opening 44 in the outer tube 32,the opening 44 is not fully blocked. In this regard, because thecross-section of the opening 44 is larger (i.e., oblong) than thecross-section of the tapered distal tip 122, fluid is still permitted topass around the locking member 22 and through the opening 44. At thistime, the o-rings 74 and 75 on the plug 14 (and in some examples incombination with the piston 60) cooperates to preclude any air 152 frombeing communicated through the proximal end 42 of the cannulated syringe12.

Once any remaining air 152 has been evacuated from the outer cannulation36, the injectable material 24 can then be hydrated. In this regard, theauxiliary syringe 140 (or another fluid delivery device) can then befluidly connected to the valve attachment 20. Those skilled in the artwill readily appreciate that a vacuum can be maintained within the outercannulation 36 during the transition from evacuating the air 152 fromthe outer cannulation 36 and the introduction of hydrating fluid 154into the auxiliary syringe 140. In other examples, a secondary fluiddelivery device (not specifically shown) can be used for hydrating theinjectable material 24. Such a secondary fluid delivery device can befluidly coupled to the valve attachment 20.

With reference to FIGS. 7 and 8, the hydrating fluid 154 can be injectedthrough the female receiving portion 142 and subsequently through theinjection port 116 of the valve attachment 20. The hydrating fluid 154can be any suitable hydrating fluid. In some examples, the hydratingfluid 154 can contain patient marrow. The fluid 154 then can communicatearound the annular channel 102 formed in the valve body 18 and enter theouter cannulation 36 through the opening 44 around the tapered distaltip 122 of the locking member 22. Once the injectable material 24 hasbeen sufficiently hydrated, the consistency of the injectable material24 can become viscous or flowable.

With reference now to FIGS. 8 and 9, the surgeon can then remove thelocking member 22 from the valve body 18 thereby unlocking the valvebody 18 from the cannulated syringe 12. The valve body 18 can then beslidably translated along the distal end 40 toward the tapered distaltip 46 and off of the cannulated syringe 12. The plug 14 can also beslidably withdrawn from the proximal end 42 of the cannulated syringe12.

With reference now to FIGS. 10 and 11, the inner cannulation 34 of thecannulated syringe 12 can be located onto a guide wire 160. Thecannulated syringe 12 can then be advanced into an IM canal 162 of thetibia, such that the guide wire 160 slidably locates through the innercannulation 34 of the cannulated syringe 12. The IM canal 162 is shownpartially reamed. In this regard, a cannulated reaming bit (not shown)can be guided along the guide wire 160 as needed. The cannulated reamingbit can then be withdrawn from the IM canal 162 with the guide wire leftin place. The guide wire, substantially undisturbed, can then bereferenced by the cannulated syringe 12. It will be appreciated that theinner tube 30 of the cannulated syringe 12 can provide a barrier betweenthe hydrated injectable material 24 and the guide wire 160.

Once the tapered distal tip 46 of the cannulated syringe 12 has beenadvanced to the desired location in the IM canal, the distal end 78 ofthe plunger 16 can be located into the outer cannulation 36 at theproximal end 42 of the cannulated syringe 12. Explained in greaterdetail, the tubular body 76 of the plunger 16 can be advanced toward thedistal end 40 of the cannulated syringe 12 while the cannulation 82 ofthe plunger 16 receives the inner tube 30 of the cannulated syringe 12(and the guide wire 160). As can be appreciated, the tubular body 76 canlocate within the outer cannulation 36 of the cannulated syringe andexpel the injectable material 24 through the opening 44 as the plunger16 progressively advances distally through the outer cannulation 36. Asurgeon can grasp the handle 50 of the cannulated syringe 12 with onehand and grasp the gripping portion 84 of the plunger 16 with the otherhand to manipulate the respective cannulated syringe 12 and plunger 16in a desired manner.

Once the desired amount of injectable material 24 has been delivered tothe delivery site, the plunger 16 together or in sequence with thecannulated syringe 12 can be withdrawn from the guide wire 160. Othersteps may optionally be carried out using the guide wire 160 asreference. An implant, such as an IM nail can then be implanted. Oneexemplary IM nail is disclosed in U.S. Pat. No. 6,652,528, Vandewalle,issued Nov. 25, 2003 entitled “Intramedullary Nail with Modular Sleeve,”the contents of which are expressly incorporated herein by reference.Other IM nails may also be used.

Non-Limiting Discussion of Terminology

The headings (such as “Introduction” and “Summary”) and sub-headingsused herein are intended only for general organization of topics withinthe present disclosure, and are not intended to limit the disclosure ofthe technology or any aspect thereof. In particular, subject matterdisclosed in the “Introduction” may include novel technology and may notconstitute a recitation of prior art. Subject matter disclosed in the“Summary” is not an exhaustive or complete disclosure of the entirescope of the technology or any embodiments thereof. Classification ordiscussion of a material within a section of this specification ashaving a particular utility is made for convenience, and no inferenceshould be drawn that the material must necessarily or solely function inaccordance with its classification herein when it is used in any givencomposition.

The description and specific examples, while indicating embodiments ofthe technology, are intended for purposes of illustration only and arenot intended to limit the scope of the technology. Moreover, recitationof multiple embodiments having stated features is not intended toexclude other embodiments having additional features, or otherembodiments incorporating different combinations of the stated features.Specific examples are provided for illustrative purposes of how to makeand use the compositions and methods of this technology and, unlessexplicitly stated otherwise, are not intended to be a representationthat given embodiments of this technology have, or have not, been madeor tested.

As used herein, the words “desire” or “desirable” refer to embodimentsof the technology that afford certain benefits, under certaincircumstances. However, other embodiments may also be desirable, underthe same or other circumstances. Furthermore, the recitation of one ormore desired embodiments does not imply that other embodiments are notuseful, and is not intended to exclude other embodiments from the scopeof the technology.

As used herein, the word “include,” and its variants, is intended to benon-limiting, such that recitation of items in a list is not to theexclusion of other like items that may also be useful in the materials,compositions, devices, and methods of this technology. Similarly, theterms “can” and “may” and their variants are intended to benon-limiting, such that recitation that an embodiment can or maycomprise certain elements or features does not exclude other embodimentsof the present technology that do not contain those elements orfeatures.

Although the open-ended term “comprising,” as a synonym ofnon-restrictive terms such as including, containing, or having, is usedherein to describe and claim embodiments of the present technology,embodiments may alternatively be described using more limiting termssuch as “consisting of” or “consisting essentially of.” Thus, for anygiven embodiment reciting materials, components or process steps, thepresent technology also specifically includes embodiments consisting of,or consisting essentially of, such materials, components or processesexcluding additional materials, components or processes (for consistingof) and excluding additional materials, components or processesaffecting the significant properties of the embodiment (for consistingessentially of), even though such additional materials, components orprocesses are not explicitly recited in this application. For example,recitation of a composition or process reciting elements A, B and Cspecifically envisions embodiments consisting of, and consistingessentially of, A, B and C, excluding an element D that may be recitedin the art, even though element D is not explicitly described as beingexcluded herein.

When an element or layer is referred to as being “on”, “engaged to”,“connected to” or “coupled to” another element or layer, it may bedirectly on, engaged, connected or coupled to the other element orlayer, or intervening elements or layers may be present. In contrast,when an element is referred to as being “directly on”, “directly engagedto”, “directly connected to” or “directly coupled to” another element orlayer, there may be no intervening elements or layers present. Otherwords used to describe the relationship between elements should beinterpreted in a like fashion (e.g., “between” versus “directlybetween,” “adjacent” versus “directly adjacent,” etc.). As used herein,the term “and/or” includes any and all combinations of one or more ofthe associated listed items.

1. A set of instruments configured to introduce an injectable material to a bone, the set of instruments comprising: a cannulated syringe extending along a longitudinal axis between a proximal and a distal end, the cannulated syringe having an inner tube and an outer tube that are interconnected at the distal end as a single fixed unit, wherein a first cannulation is formed along the longitudinal axis of the cannulated syringe within the inner tube and a second cannulation is formed within an annular space between the inner and outer tubes, wherein the distal end of the cannulated syringe defines an opening, and wherein the cannulated syringe is closed from fluid communication between the inner and outer tubes.
 2. The set of instruments of claim 1 wherein the opening is formed in the outer tube and comprises an oblong slot.
 3. The set of instruments of claim 1 wherein the inner tube is longer than the outer tube such that the inner tube extends proud from the proximal end relative to the outer tube.
 4. The set of instruments of claim 3 wherein the cannulated syringe includes a handle disposed on the proximal end that extends generally transverse to the longitudinal axis.
 5. The set of instruments of claim 1, further comprising: a plunger having a tubular body that is configured to slidably advance through the second cannulation in a direction toward the distal end.
 6. The set of instruments of claim 5 wherein the plunger has a gripping portion disposed on a proximal end thereof.
 7. The set of instruments of claim 5, further comprising: a piston having a tubular body that is configured to slidably advance through the second cannulation upon urging from the plunger.
 8. The set of instruments of claim 5, further comprising: a valve body having a central passage that is sized to slidably advance onto the distal end of the cannulated syringe in an operating position, the valve body having a locking aperture and a valve inlet formed thereon, wherein the valve inlet is adapted to fluidly connect with the opening of the outer tube in the operating position; and a locking member that is adapted to selectively locate through the locking aperture of the valve body and into the opening of the outer tube thereby inhibiting slidable translation of the valve body along the outer tube of the cannulated syringe.
 9. The set of instruments of claim 8 wherein the valve body has an annular channel formed around an inner diameter that fluidly connects the valve inlet and the opening in the outer tube of the cannulated syringe in the operating position.
 10. The set of instruments of claim 9 wherein the locking member is adapted to create a fluid tight seal at the locking aperture in an installed position.
 11. The set of instruments of claim 10 wherein the locking member has a distal end that has a cross-section less than the opening in the outer tube such that fluid is permitted to pass through the opening in the outer tube when the locking member is in the installed position.
 12. The set of instruments of claim 8, further comprising: a plug having a tubular body that is configured to slidably advance through the second cannulation in a direction toward the distal end, the plug having a collar on a proximal end that is adapted to engage a proximal terminal end of the outer tube in an advanced position while the inner tube locates through the tubular body of the plug, the plug further having elastomeric seals at distal and proximal ends that are adapted to form a fluid tight seal between the inner and outer tubes in the advanced position.
 13. The set of instruments of claim 5, further comprising: a valve attachment disposed on the valve body and that is fluidly connected to the valve inlet, the valve attachment having threads formed thereon that are adapted to threadably mate with a fluid delivery device.
 14. A method of introducing an injectable material into a bone, the method comprising: locating the injectable material into an outer cannulation of a cannulated syringe; passing a guide wire extending from an IM canal of the bone at least partially through an inner cannulation of the cannulated syringe, wherein the inner and outer cannulations are fixed relative to each other and closed from fluid communication by an inner tube of the cannulated syringe; advancing the cannulated syringe along the guide wire until an opening provided in the cannulated syringe is located proximate to a delivery site; and advancing a plunger distally through the outer cannulation of the cannulated syringe thereby expelling the injectable material through the opening at the delivery site.
 15. The method of claim 14, further comprising: evacuating air from the outer cannulation of the cannulated syringe; and hydrating the injectable material within the outer cannulation of the cannulated syringe, wherein the evacuating and hydrating are both performed subsequent to locating the injectable material into the outer cannulation and prior to advancing the plunger.
 16. The method of claim 15 wherein evacuating air further comprises: sealing a proximal end of the outer cannulation; connecting a fluid transfer device to the cannulated syringe at a location distally relative to the injectable material, the fluid transfer device fluidly communicating with the outer cannulation through the opening; operating the fluid transfer device to create a vacuum within the inner cannulation.
 17. The method of claim 16 wherein sealing the proximal end of the outer cannulation further comprises: advancing a plug into the outer cannulation, the plug having seal members that are adapted to create a fluid tight seal in the outer cannulation, the plug further having a central opening that slidably receives the inner tube.
 18. The method of claim 15 wherein hydrating the injectable material further comprises: introducing a hydrating fluid through the opening while a vacuum is maintained in the outer cannulation.
 19. The method of claim 18 wherein hydrating the injectable material further comprises: slidably advancing a valve body onto a distal end of the cannulated syringe until a locking aperture in the valve body substantially aligns with the opening in the cannulated syringe, the valve body creating a fluid tight seal around the opening; and passing a locking member through the locking aperture and into the opening in the cannulated syringe thereby inhibiting the valve body from further translating along the cannulated syringe.
 20. The method of claim 18 wherein introducing the hydrating fluid through the opening further comprises: urging the hydrating fluid through a valve inlet defined through the valve body and into the opening in the cannulated syringe, the hydrating fluid communicating around an annular channel formed along an inner diameter of the valve body that fluidly connects the valve inlet and the opening. 